莪术油洗脱支架防治犬冠状动脉支架术后再狭窄的实验研究

Effect of Zedoary Turmeric Qil-eluting Stents for Post-stenting Restenosis Prevention and Treatment

目的观察莪术油洗脱支架防治犬冠状动脉支架术后再狭窄的安全性及疗效。方法将裸支架、聚甲基丙烯酸丁酯/纳米二氧化硅涂层支架、莪术油洗脱支架(药物含量100μg/支架)随机置入犬冠状动脉回旋支或前降支,术后4周冠脉造影后处死分析支架段血管组织形态学变化。结果光镜下可见裸支架组和单涂层组支架段血管内膜增厚,莪术油组内膜较薄,均未见内膜下出血和中膜、外膜坏死,无附壁血栓和炎性细胞浸润;扫描电镜观察各组内皮完整。组织形态学分析结果显示:与裸支架和涂层支架比较,莪术油洗脱支架显著减少了新生内膜厚度、新生内膜面积、管腔面积狭窄率(P<0·01),增加了管腔面积(P<0·01);裸支架组与单涂层组比较,差异无统计学意义(P>0·05)。结论莪术油洗脱支架安全可行,显著抑制了犬冠状动脉支架术后内膜增生,具有防治再狭窄作用。

Objective To investigate the effect and safety of Zedoary Turmeric Oil （ZTO）-eluting stents for post-coronary stenting restenosis prevention and treatment in the experimental dogs. Methods Bare stents, stents coated with polybutyl methacrylate/Nano silica, and stents eluted with 100 μg ZTO were randomly deployed in canine anterior descending or circumflex coronary artery. Four weeks after stent implantation, the dogs were sacrificed and the vascular histomorphologic changes in the stenting segment analyzed. Results Thickened intima could be seen under light microscope in the bare or coated stents, but thinner in ZTO-duting stent, with no sub-intimal hem- orrhage, medial or adventitial necrosis, wall adhesive thrombus, or infiltration of inflammatory cells. Scanning electric microscopy showed the intima was intact. Histomorphologic analysis showed that the thickness and area of neo-intima, and the lumen stenosis percent in artery stented with ZTO eluting stents were significantly lower than those stented with bare or coated stents （P 〈0. 01 ）, and thus the lumen cavity was expanded （P 〈0. 01 ）, while no statistic significant difference between polymer and bare stents was found （P 〉 0.05）. Conclusion ZTO-eluting stem is available and safe, and it could significantly inhibit the growth of neo-intimal in canine coronary mode after stenting, showing a restenosis preventive and treatment effect.